中国实用外科杂志

中国实用外科杂志

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动脉内膜剥脱术治疗颈动脉狭窄179例临床分析

乔    彤，刘长建，黄    佃，刘    晨，冉    峰，王    炜，张    明，周    敏   

  1. 南京大学医学院附属鼓楼医院血管外科，江苏南京210008
  • 发布日期:2012-07-30

  • Published:2012-07-30

摘要：

目的    分析颈动脉内膜剥脱术后并发症的原因，探讨其防治措施。方法    回顾性分析南京大学医学院附属鼓楼医院血管外科收治的因严重颈动脉狭窄行颈动脉内膜剥脱术179例。其中标准式颈动脉内膜剥脱术（SCEA）87例，外翻式颈动脉内膜剥脱术（ECEA）92例。转流管使用35例，均为SCEA术式。结果    所有手术操作顺利。围手术期内发生急性颈动脉血栓形成1例、脑梗死2例、脑出血2例、暂时性失读1例、舌下神经损伤1例、声音嘶哑1例、伤口血肿3例。围手术期死亡1例。结论    手术指征不严、术中操作失误、术后处理不当是导致相关并发症的主要因素。对于并发症的发生重在预防，发生后必须准确判断、处理迅速。

关键词: 颈动脉狭窄, 颈动脉内膜剥脱术

Abstract:

Prevention and management of postoperative complications of carotid endarterectomy        QIAO Tong, LIU Chang-jian, HUANG Dian, et al. Department of Vascular Surgery, Drum Tower Hospital, Affiliated Hospital of Medical College, Nanjing University, Nanjing 210008, China
Corresponding author: QIAO Tong, E-mail: qiaotonghome@hotmail.com
Abstract    Objective    To study the reasons of complications after carotid endarterectomy (CEA), and discuss the prevention and management. Methods    The data of 179 cases of severe carotid artery stenosis (CAS) treated by CEA at Drum Tower Hospital, Affiliated Hospital of Medical College, Nanjing University were analyzed retrospectively. All the cases included 87 cases of standard carotid endoarterectomy (SCEA) and 92 cases of eversion carotid endoarterectomy (ECEA). The shunts were used in 35 cases, which were all treated by SCEA. Results    All procedures were successful. The postoperative complications included aute ICA thrombosis in 1 case, cerebral infarction in 2 cases, cerebral hemorrhage in 2 cases, temporary alexia in 1 case, hypoglossal nerve injury in 1 case, superior laryngeal nerve injury in 1 case and wound hematoma in 3 cases. One case of death resulted from cerebral hemorrhage in perioperative period. Conclusion    The complications of CEA result from incorrect operation indication, operative procedure and postoperative management. The prevention of complication is very important. The complications must be diagnosed exactly and treated as soon as possible.

Key words: carotid artery stenosis, carotid endarterectomy